I found out that I had hearing loss when I was around 9 years old. A few years later, I tried hearing aids. My hearing got worse and worse over the years, and I encountered increasingly challenging situations.
I was at a concert one summer when the violinist suddenly stopped playing. I looked around, confused. Then the song came down from the high register, and I could hear it again. I realized my hearing was now bad enough that I couldn’t hear high sounds at all. On one scary occasion, I discovered I couldn’t hear the fire alarm at the law school library. When I walked right by the alarm, I felt the pressure on my eardrum, but as loud as it was, I couldn’t hear the alarm at all.
I finally went to see an audiologist at the University of Virginia hospital, and they put me through a battery of tests. My scores were so low that it was clear to them that hearing aids wouldn’t help me much with understanding speech because hearing aids couldn’t do anything for the highest pitches. The audiologist recommended that I get a traditional cochlear implant, but then I failed the qualifying tests for the traditional cochlear implant. The problem was that even though my actual hearing was too poor for hearing aids to help me in a meaningful way, my functional hearing was too good for me to qualify for a traditional cochlear implant.
So I soldiered on. I graduated from law school and got my first job. After a little over a year, I read an article on the internet about the new Cochlear™ Nucleus® Hybrid Implant**. It was recently approved and the only device of its kind in the U.S. The beauty of the Hybrid is that it combines two kinds of hearing: electric hearing with natural acoustic hearing. A traditional cochlear implant replaces all of the hearing in one ear with electronic impulses that the brain learns to interpret as sound. The Nucleus® Hybrid replaces the highest frequencies with electronic impulses, and can leave some of the natural hearing in the lower frequencies. For someone like me, who had terrible high frequencies but still had good lows, this was the solution I was waiting for.
I saw an audiologist and otolaryngologist at an office in Provo, Utah. They tested my hearing and confirmed that I’d be a good candidate for the Hybrid L24 cochlear implant. I asked a lot of questions. We had to jump through a few hoops for insurance, and I made arrangements with my very understanding employer. Then it was time for surgery.
As much research as I’d done, and as confident as my doctor was, going into surgery was terrifying. There were some very real risks. Every surgery involving general anesthesia carries some risks. And there was a very good chance that I’d lose quite a bit of what hearing I still had left in that ear. I had the support of my family and went forward with surgery.
Eventually we would discover that my surgeon had accomplished the rare feat of retaining all of my residual hearing. I didn’t lose any of the hearing I had before surgery. The only change was what I’d gained.
On activation day a couple of weeks after surgery, my audiologist plugged my sound processor into his computer, calibrated, and placed the magnet on my head. I’ve seen videos of miraculous activations, where people hear a loved one’s voice for the first time. That wasn’t me. My own transformation was equally miraculous, but took a little more time.
For the first three weeks, I had to gradually work my way up in volume. You know that feeling when you’ve been in a dark basement for a few hours and then you step outside and the sunlight is way too bright? Imagine you’d been in the basement for nineteen years. It’s like that, but with sound. I had to start quiet and work my way up until I could tolerate a normal level of sound in the high frequencies I wasn’t used to hearing.
While I did have some face time with an aural pathologist and, of course, my audiologist, my primary form of therapy was audiobooks. I listened exclusively on my implanted ear, using the completely wireless Mini Mic and Phone Clip devices I got with the processor. That’s what taught me to understand speech again.
One evening, I was resting on the couch in our living room, fiddling with my processor. “Emily,” I called to my wife. “Yes?” “I think there’s something wrong with my implant. It might be the battery. There’s like this rhythmic clicking.” I moved my hand along with the steady rhythm. “It’s driving me nuts.” Emily laughed. “Joe, there’s a clock on the shelf behind you.” I was aghast. “You can hear that all the time?” That just goes to show how powerful our natural filters are.
In another especially poignant moment, I called Emily out to the porch of my parents’ farmhouse in New York, where we were spending Christmas. “Do you hear birds singing?” “…Yep. That’s birds. There’s a few over in that tree.” I just grinned. I hadn’t heard birds for years.
I made some other milestones as I grew more comfortable with the implant. I took a road trip with my family and held a whole conversation from the driver’s seat without angling the rear-view mirror to watch Emily’s mouth while she talked. I ordered fast food from a drive-through without asking the employee to repeat anything. My son whispered to me as I was leaving his room at night, and I turned back around to answer his request with another goodnight kiss. I had a conversation with my wife from another room.
Recently, I attended a string quartet concert. I was emotionally moved by the full sound of the blended instruments. It’s not just that I could hear the high notes, though I could. Even the cello’s sound fills a swath of the audible spectrum. Before the implant, I could only hear the bottom half to two-thirds of the sound. But there’s a crispness, a cresting, soaring purity that sings from the strings, and that’s all in the upper register. I heard and appreciated that for the first time just a few weeks ago.
I had to admit to myself in law school that I’d never make my living in the courtroom, with my handicap. But recently I represented a client at a court hearing. Not only that, but I participated by telephone. The phone was my nemesis for years—no visual cues, often less than a perfect signal—but I didn’t miss a beat. It was a tremendous personal victory.
Getting the Hybrid cochlear implant was scary, and there were tough moments as I acclimated to the device. But it has been an absolute miracle for me. My world has opened up. Doors that were once barred shut for me in my career are open now. The beauty of music has taken on a whole new level. And I can understand so much more of what is said around me. It’s not for everyone, but it was right for me. My many prayers were finally answered through the research of many and the hands of one capable surgeon. And I’ll never stop being grateful for that.
*Hybrid Hearing should only be used when behavioral audiometric thresholds can be obtained and the recipient can provide feedback regarding sound quality.
**The Hybrid L24 Implant is approved in the US for adults ages 18 and older.
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